The Foreign Service Journal, September 2010

S E P T E M B E R 2 0 1 0 / F O R E I G N S E R V I C E J O U R N A L 25 Only when he returned to the United States for a break did he talk to a doctor who said Lexipro was not working. He switched to Zoloft, another antidepressant, but his condition went from bad to worse. He was evac- uated and placed in a psychiatric hospitalization program in Washington. In a meeting with the clinical director of MED, the officer was told that the odds were against him returning to post. He was crestfallen, worrying that his career was sunk and that he couldn’t finish the work he’d started, but he kept his hopes up. He was told that there re- mained a 1-in-3 chance that he could go back. MED provided no help, he says, in finding a psychia- trist skilled in dealing with PTSD cases, so he found one on his own. But two weeks after his discussion with the clinical director, he was told he would not be returning to post. Soon thereafter, though, he was assigned to another country. The symptoms started coming back and he was evacuated again. He found himself living in Washington, D.C., apart from his wife, trying to get better while filing appeals to be able to return to work. He’s been granted a Class 2 medical clearance, which allows him to go to posts where he could be treated, if need be, for PTSD. But he continues to believe that if his case had been han- dled better at the start, all this might have been avoided. Maintaining a Tricky Balance MED officials are eager to dispel such fears. They in- sist that even where mental health issues are raised in evaluating whether or not a security clearance is renewed — as is required throughout the federal government — MED takes steps to ensure that an individual’s doctor is not put into a position of working against him or her. In those proceedings, a separate physician reviews the mental health records and makes a recommendation to DS about whether those findings should preclude a clearance. The process is more adversarial, though, when MED is called in to investigate by the Bureau of Diplomatic F O C U S